Provider Demographics
NPI:1760598403
Name:CHIANG, MYRA L (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRA
Middle Name:L
Last Name:CHIANG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:830 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-3302
Mailing Address - Country:US
Mailing Address - Phone:304-388-1541
Mailing Address - Fax:304-388-1577
Practice Address - Street 1:830 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-3302
Practice Address - Country:US
Practice Address - Phone:304-388-1541
Practice Address - Fax:304-388-1577
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-01-07
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Provider Licenses
StateLicense IDTaxonomies
WV154972080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVC14433Medicare UPIN